BOSTON - The 1,200 registered nurses at Tufts Medical Center, who are represented by the Massachusetts Nurses Association, are prepared to return to caring for their patients at 7 a.m. Thursday, July 13 following the conclusion of their one-day strike for safe patient care, fair retirement benefits and market competitive wages.

Click on image for a larger version

Click on image for a larger version

Nurses began an historic one-day strike Wednesday morning as Tufts management failed to agree to a fair settlement that ensures patients have the highly skilled nursing care they deserve. The strike - the first by nurses in Boston in 30 years and largest nurses' strike in Massachusetts history - is scheduled to last until 6:59 a.m. on July 13. Tufts management has threated to lock out nurses following the 24-hour strike for an additional four days, bringing in mercenary replacement nurses who do not know Tufts patients, staff, the hospital or community.

"Our 24-hour strike was necessary because the hospital refused to negotiate a fair agreement that protects our patients and values our nurses. The strike has shown the incredible strength that comes when Tufts nurses and our community stand together," said Mary Havlicek Cornacchia, an OR nurse and bargaining unit co-chair. "Tufts nurses are ready to return to work and care for our patients on Thursday morning. If the hospital follows through on its threat to lock us out for four days, that decision and its consequences will entirely be the responsibility of Tufts Medical Center."

RN Public Schedule for Thursday-Monday

6:59 a.m. Thursday, July 13: One-day RN strike ends. Nurses will gather outside the hospital at 800 Washington St. in Boston and those scheduled to work plan to enter Tufts to care for their patients. The hospital has threatened to lock out nurses for four days.

7 a.m. Monday, July 17: Tufts' threatened four-day lock-out is scheduled to end. Nurses will be ready then, as they will be on Thursday morning, to return to caring for their patients and fighting for a fair agreement.

Tufts nurses are seeking much needed improvements in staffing levels to ensure nurses have more time to spend with patients as well as an increase in their salary to keep them competitive with other Boston hospitals (Tufts nurses are the lowest paid nurses in the city) and to preserve and enhance their pension benefit (which is also the worst in the city).

"Instead of caring for our patients, the nurses of this hospital will be out on the strike line tomorrow to demonstrate our resolve and our commitment to fight for what is best for our patients and our professional practice," said Barbara Tiller, union co-chair and an IV/PICC/CRN nurse. "We have been trying for months to convince Tufts management that our patients and nurses are suffering because they refuse to provide us with the resources, appropriate patient assignments, and the compensation we need to ensure quality patient care."

The Truth about Tufts Strike Replacement Nurses

During the 24-hour strike by Tufts nurses, TMC management planned to bring in mercenary replacement nurses from all over the country who do not know the hospital, are not highly specialized like the Tufts nurses, and who the Massachusetts Nurses Association believes will endanger patient care.

History, academic studies and unionized registered nurses can all testify to the fact that mercenary replacement nurses cannot make up for the temporary loss of nurses who are specialized in their fields and knowledgeable of their patients and the hospital systems. A 2010 study by the National Bureau of Economic Research concluded, "Hiring replacement workers apparently does not help: hospitals that hired replacement workers performed no better during strikes than those that did not hire substitute employees."

During the 2000 strike by the MNA nurses at St. Vincent Hospital in Worcester, three replacement nurses recruited by the same strike replacement nurse agency Tufts plans to use were fired after separate incidents in which they left a patient alone after surgery and also gave the wrong baby to a nursing mother, according to news reports by the Worcester Telegram & Gazette and WCVB Channel 5. Another patient was given a nearly fatal overdose of morphine because a replacement nurse misunderstood a doctor's order, according to Channel 5.

"It can take several weeks to train even an experienced nurse to provide quality care under normal conditions in a new hospital setting," said Havlicek Cornacchia. "How can they possibly expect to safely operate this hospital with nurses drawn from all parts of the country who have no experience with our facility? It is irresponsible. Instead of issuing ultimatums and spending millions of dollars to ignore us, they should have listened to us and offered a fair settlement."

Key Issues in Dispute

· The need for improved nurse staffing with safer patient assignments for nurses throughout the hospital

· The need for more IV nurses and clinical resource nurses

· The need to have charge nurses who are free of patient assignments at the start of all shifts, in all units. A charge nurse is an RN who is responsible for managing all aspects of nursing responsibilities during each shift, from processing patients in and out to delegating nursing rounds. Being free of an initial patient assignment will allow Tufts' charge nurses to provide desperately needed support to patients and nurses at the busiest time (i.e., change of shift)

· The need for wage improvements that will make the hospital market competitive, thereby improving nurse recruitment and retention

· The need for pension protections/improvements that will make the hospital market competitive

Concerns over Safe Staffing and Safe Patient Care

In the current environment at Tufts, nurses across all units and floors are contending with unsafe staffing situations on a daily basis, with many units reporting constant unsafe staffing levels. The result is too many RNs are regularly carrying patient assignments that are too large and unsafe. Every day, the hospital sends RNs blast-text messages asking them to pick up shifts that are open due to the bare-bones approach management uses to staff the hospital.

Simultaneously, hospital management insists on using a fragmented and broken system of temporary reassignment as a way of trying to deal with its chronic staffing challenges. This results in RNs being directed to work on units and floors where they are unfamiliar and/or untrained to safely care for patients. In addition, there are not enough specialty nurses to help with patients' IV needs or in an emergency.

"We have offered a variety of proposals -- and amended proposals, and doubly amended proposals -- that would address staffing," said Tiller. "But management's responses have been so inadequate that they don't get to the heart of the problem. They insist on offering us staffing proposals that are disjointed and superficial. What we need from them is simple: more full-time RNs and specialty nurses, and charge nurses without an initial patient assignment. That's what will keep our patients safe."

Market Competitive Compensation

In addition to having some of the worst staffing conditions in Boston, Tufts Medical Center has also become the hospital that offers its nurses the lowest wages and retirement benefits in the city. "The hospital's proposals have not adequately addressed these issues," said Havlicek Cornacchia. "Without market competitive wages and benefits, Tufts cannot recruit and retain the nurses it needs, and the staffing problem spirals downward."

Management has also proposed freezing the defined benefit pension plan for approximately 350 RNs and instituting a divisive, inequitable, and complex catchup mechanism as part of a proposed higher-risk 403(b) matching program. That change would result in significant losses in retirement funding for most nurses. Meanwhile, RNs already in the defined contribution plan would continue to receive the lowest employer contribution of all nurses in the city.

The nurses have countered with an innovative proposal that would benefit all RNs while still saving the hospital millions of dollars annually. This proposed plan, which is a multi-employer defined benefit pension plan, would add as much as $11 million to Tufts' bottom line, would eliminate more than $85 million in pension liability. Management has refused to engage in any real talks on this issue.

"The pay and retirement benefits at Tufts just aren't competitive," said Tiller. "We know it, Tufts knows it, and the other hospitals in the city know it. As a result, we've become the nurse training ground for all the other facilities. New graduates come here, they get their experience, and they move on. This cycle won't stop until the hospital makes us competitive. And in the meantime, our patients suffer."